Rohozynskyi V. The use of halo-gravitational traction in the treatment of complex spinal deformities in children

Complex scoliotic deformities in children (> 100) according to the modern literature range from 0.12% to 1.7% among other scoliotic spinal deformities. Modern surgical practice of one-step correction of heavy scoliotic spinal deformities includes the use of Ponte osteotomies and Vertebral Column Resection (VCR), which increases the possibility of deformity correction, but also increases the risk of neurological complications, the volume of intraoperative blood loss. The definition of "complex spinal deformity" remains unclear, but in most publications it is referred to as deformation which goes beyond 100. Halo-gravitational traction (HGT) is a safe and effective method for pre-correcting complex spinal deformities before volume correction at the rate of posterior spinal instrumentation. Halo-gravitational traction (HGT) is a safe technique because the world literature has described complications such as pin loosening or superficial skin infections around the pins that are insignificant and not life-threatening. The use of HGT can improve lung ventilation, which in turn reduces the risk of death from pulmonary insufficiency in adulthood. The purpose of the study was to improve the results of surgical treatment of heavybscoliotic spinal deformities in children by substantiating and developing new, improving existing methods of halogravity traction, to improve the results of pulmonary ventilation due to previous use of HGT in patients with complex spinal deformities; to establish an effective and safe algorithm for the treatment of complex spinal deformities in children with respiratory dysfunctions. The following tasks were defined, according to the study purpose: 1. To conduct a systematic analysis of the scientific literature regarding modern trends of existing methods and technologies of using halo-gravitational traction in the system of surgical correction of complex scoliotic spinal deformities in children. 2. To develop a mathematical model "spine - system of halo-gravitational traction" and conduct research using the finite element method of the distribution of internal stresses in it during stretching. 3. To improve and introduce into clinical practice new approaches to the use of halo-traction traction in the system of surgical treatment of complex scoliotic spinal deformities in children. 4. To investigate changes in external breathing in patients with complex spinal deformities when using halo-traction traction. 5. To evaluate the results of staged surgical treatment using halo-gravitational traction in patients with complex spinal deformities and a control group of patients. According to the analysis of the literature sources, it was determined that two-stage treatment of severe scoliotic spinal deformities using halo-gravity extraction gives positive results after surgical correction, but the effectiveness, methodology and long-term prognosis in halo-gravity traction in patients with complex scoliotic deformities this time continue a matter of opinion.